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Clinical Toxicology

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https://www.readbyqxmd.com/read/29219630/fewer-adverse-effects-with-a-modified-two-bag-acetylcysteine-protocol-in-paracetamol-overdose
#1
Richard McNulty, Jia Min Elizabeth Lim, Pramod Chandru, Naren Gunja
OBJECTIVE: Acetylcysteine (NAC), an effective antidote for paracetamol poisoning, is commonly associated with adverse reactions. This has been postulated to be related to the rapid initial infusion rate (150 mg/kg over 1 h) of the traditional three-bag protocol. We hypothesized that a slower rate would result in fewer adverse reactions. Our institution in Western Sydney moved to a modified two-bag protocol in February 2015 - first bag: 200 mg/kg over 4 h (50 mg/kg/h) and second bag: (100 mg/kg over 16 h)...
December 8, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29205070/trends-in-types-of-calls-managed-by-u-s-poison-centers-2000-2015
#2
Bruce D Anderson, Hyunuk Seung, Wendy Klein-Schwartz
AIM: The number of cases reported to poison centers has decreased since 2008 but there is evidence that the complexity of calls is increasing. OBJECTIVES: The objectives are to evaluate national poison center data for trends in reason and how these changes effect management site, medical outcomes, and poison center workload. METHODS: Data regarding reason, age, management site, and medical outcome were extracted from annual reports of the National Poison Data System from 2000 to 2015...
December 5, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29199873/disposition-of-toxic-drugs-and-chemicals-in-man-11th-edition
#3
Robin Ferner
No abstract text is available yet for this article.
December 4, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29188723/cryogenic-dermal-injuries-to-the-chest-secondary-to-inhalational-abuse-of-keyboard-cleaner
#4
Mohan Punja, Dennis Bradley Langston, Maurice Walter Smith
No abstract text is available yet for this article.
November 30, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29172805/letter-in-response-to-levetiracetam-in-toxic-seizures
#5
Michelle A Hieger, Kevin F Maskell
No abstract text is available yet for this article.
November 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29172738/authors-response-to-letter-on-levetiracetam-in-toxic-seizures
#6
Ted Lee, Brandon J Warrick, Preeyaporn Sarangarm, Robert L Alunday, Silas Bussmann, Susan C Smolinske, Steven A Seifert
No abstract text is available yet for this article.
November 27, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29172744/identification-of-mothball-powder-composition-by-float-tests-and-melting-point-tests
#7
Ka Yuen Tang
INTRODUCTION: The aim of the study was to identify the composition, as either camphor, naphthalene, or paradichlorobenzene, of mothballs in the form of powder or tiny fragments by float tests and melting point tests. METHODS: Naphthalene, paradichlorobenzene and camphor mothballs were blended into powder and tiny fragments (with sizes <1/10 of the size of an intact mothball). In the float tests, the mothball powder and tiny fragments were placed in water, saturated salt solution and 50% dextrose solution (D50), and the extent to which they floated or sank in the liquids was observed...
November 24, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29172731/a-verified-bite-by-heteroscodra-maculata-togo-starburst-or-ornamental-baboon-tarantula-resulting-in-long-lasting-muscle-cramps
#8
Joan Fuchs, Nadine C Martin, Christine Rauber-Lüthy
No abstract text is available yet for this article.
November 24, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29168404/impact-of-a-chronic-pain-management-pathway-on-opioid-administration-and-prescribing-in-an-emergency-department
#9
Caroline Pace, Sneha Shah, Amy X Zhang, Amy E Zosel
CONTEXT: Prescription opioid abuse and misuse is a significant public health crisis. In 2012, an opioid prescribing pathway for patients with chronic pain presenting to the Emergency Department (ED) was implemented. The objective of this study is to determine the impact of the pathway for administration of opioids in the ED as well as the prescribing of opioids for home use after discharge. METHODS: Retrospective pre- and post-intervention time series study of consecutive patients presenting to the ED with acute and chronic pain complaints before and after implementation of the pathway...
November 23, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29164951/letter-in-response-to-acquired-methemoglobinemia-after-hydroxocobalamin-administration-in-a-patient-with-burns-and-inhalation-injury
#10
Ryland W Pace, Daniel Lugassy, Robert S Hoffman
No abstract text is available yet for this article.
November 22, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29156998/exposures-to-automatic-dishwashing-rinse-aids-reported-to-the-united-kingdom-national-poisons-information-service-2008-2016
#11
Rachael C Day, Sally M Bradberry, Euan A Sandilands, Simon H L Thomas, John P Thompson, Allister Vale
OBJECTIVE: To determine the toxicity of rinse aids which are used as drying aids to remove water from crockery. METHODS: Enquiries to the UK National Poisons Information Service (NPIS) were analysed retrospectively for the period January 2008 to December 2016. RESULTS: There were 855 enquiries relating to 828 patients; children aged 5 years or less accounted for 91.1%. Most exposures occurred from ingestion alone (n = 778, 94.0%), but 26 involved ingestion and other routes: 21 with skin contact, 3 with eye contact, and two with both skin and eye contact...
November 20, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29148295/is-naloxone-the-best-antidote-to-reverse-tramadol-induced-neuro-respiratory-toxicity-in-overdose-an-experimental-investigation-in-the-rat
#12
Camille Lagard, Isabelle Malissin, Wassila Indja, Patricia Risède, Lucie Chevillard, Bruno Mégarbane
CONTEXT: Since the banning of dextropropoxyphene from the market, overdoses, and fatalities attributed to tramadol, a WHO step-2 opioid analgesic, have increased markedly. Tramadol overdose results not only in central nervous system (CNS) depression attributed to its opioid properties but also in seizures, possibly related to non-opioidergic pathways, thus questioning the efficiency of naloxone to reverse tramadol-induced CNS toxicity. OBJECTIVE: To investigate the most efficient antidote to reverse tramadol-induced seizures and respiratory depression in overdose...
November 17, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29143551/independent-validation-of-the-icu-requirement-score-in-a-cohort-of-acutely-poisoned-adults
#13
Regina Böll, Katrin Romanek, Sabrina Schmoll, Raphael Stich, Armin Ott, Jochen Stenzel, Stefanie Geith, Florian Eyer, Christian Rabe
OBJECTIVE: To independently validate the predictive value of the intensive care requirement score (IRS) in unselected poisoned patients. DESIGN: Retrospective chart review. PATIENTS AND METHODS: Five hundred and seventeen out of 585 admissions for acute intoxications could be analyzed. Eleven were excluded for a condition already requiring intensive care unit (ICU) support at admission (e.g., preclinical intubation). A further 57 admissions were excluded due to missing data...
November 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29129124/haff-disease-complicated-by-acute-lung-injury-after-crayfish-consumption-a-case-report
#14
Jian Qian, Dujuan Sha
No abstract text is available yet for this article.
November 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29129117/calls-to-poison-centers-for-hookah-smoking-exposures
#15
Sandra S Retzky, Henry A Spiller, Priscilla Callahan-Lyon
Over the past decade, smoking behaviors have changed in the US. Hookah or waterpipe smoking is increasing, especially among youth and young adults. Social media sites describe the "hookah high" or "buzz", which may be related to nicotine, carbon monoxide, or other inhalants in hookah smoke. Most important is the risk of carbon monoxide poisoning. Case reports include a high number of victims presenting with loss of consciousness from either syncope or seizures. Anaphylaxis and a very rare respiratory hypersensitivity reaction, acute eosinophilic pneumonia, have also been reported from hookah smoking in previously healthy young adults...
November 13, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29126352/fatal-myocarditis-and-rhabdomyolysis-induced-by-nivolumab-during-the-treatment-of-type-b3-thymoma
#16
Qiang Chen, Dang-Sheng Huang, Li-Wei Zhang, Yuan-Qing Li, Hong-Wei Wang, Hong-Bin Liu
Immune checkpoint inhibitors including programmed death-1 inhibitors are promising agents for many types of malignancies; however, it is still an off-label choice for type B3 thymoma. We reported for the first time a patient with type B3 thymoma developed fatal myocarditis and rhabdomyolysis after one dose of nivolumab administration. The results from myocardial and muscle biopsies revealed extensive myocyte damage, T-lymphocytic infiltration and strongly expression of PD-L1 which confirmed the nivolumab-related immune-related adverse events (irAEs)...
November 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29124988/extracorporeal-elimination-of-butalbital-in-acute-aspirin-butalbital-caffeine-codeine-fiorinal-with-codeine-poisoning
#17
Janelle O Poyant, Robert Albright, Jeremy Clain, Govind Pandompatam, Erin F Barreto
BACKGROUND: Butalbital is a small molecule (approximately 220 Da), with 26% protein binding, a 0.8 L/kg volume of distribution, and is eliminated nearly 80% unchanged in the urine. Although hemodialysis has been used to treat overdoses of other barbiturates, the extracorporeal clearance of butalbital is unknown. The objective of this case is to describe the use of extracorporeal therapy to augment elimination of butalbital after an overdose of aspirin 325 mg-butalbital 50 mg-caffeine 40 mg with codeine 30 mg (Fiorinal with Codeine)...
November 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29124976/rethinking-mercury-the-role-of-selenium-in-the-pathophysiology-of-mercury-toxicity
#18
Henry A Spiller
INTRODUCTION: There is increasing evidence that the pathophysiological target of mercury is in fact selenium, rather than the covalent binding of mercury to sulfur in the body's ubiquitous sulfhydryl groups. The role of selenium in mercury poisoning is multifaceted, bidirectional, and central to understanding the target organ toxicity of mercury. METHODS: An initial search was performed using Medline/PubMed, Toxline, Google Scholar, and Google for published work on mercury and selenium...
November 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29124975/ulnar-artery-pseudoaneurysm-and-compartment-syndrome-formation-after-snake-bite-to-the-left-forearm
#19
Lan Pin, Xie Lutao, Fang Weijun, Pan Feng, Chen Chaohui, Wu Jianrong
OBJECTIVE: To report the outcome of a patient who developed pseudoaneurysms and compartment syndrome after a Deinagkistrodon acutus snakebite. CASE REPORT: A 61-year-old man, bitten by Deinagkistrodon acutus in his left forearm, came to the hospital eight hours after the bite. Despite the use of antivenom and supportive therapy, the patient developed compartment syndrome of the left forearm, the tissue pressure was elevated and fasciotomy was arranged. During the initial surgery, part of the necrotic tissues was removed...
November 10, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/29115866/four-experimental-stimulants-found-in-sports-and-weight-loss-supplements-2-amino-6-methylheptane-octodrine-1-4-dimethylamylamine-1-4-dmaa-1-3-dimethylamylamine-1-3-dmaa-and-1-3-dimethylbutylamine-1-3-dmba
#20
Pieter A Cohen, John C Travis, Peter H J Keizers, Patricia Deuster, Bastiaan J Venhuis
BACKGROUND: The United States Food and Drug Administration banned the stimulant 1,3-dimethylamylamine (1,3-DMAA) from dietary supplements and warned consumers that the stimulant can pose cardiovascular risks ranging from high blood pressure to heart attacks. OBJECTIVES: We designed our study to determine if a new stimulant similar in structure to 1,3-DMAA has been introduced as an ingredient in supplements sold in the United States (US). METHODS: We analyzed six brands of supplements that listed an ingredient on the label (e...
November 8, 2017: Clinical Toxicology
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